Q. From my father's reports, could you advise the next step of treatment for bladder cancer?

Answered by
Dr. Devendra
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 25, 2017

Hi doctor,

My father, who is 72, was diagnosed with bladder tumor a month ago when he went to the local doctor for the treatment of blood drops in the urine. I have attached the diagnosis report for your reference. The doctors advised to operate it as soon as possible, and the operation took place 10 days ago. The biopsy report says high-grade transitional cell carcinoma of stage G3pT2. I have attached the report for your reference. Could you please advise the next step of the treatment? Please let me know if you require additional information which I have not provided with this case. Your help would be highly appreciated.

#

Hi,

Welcome to icliniq.com.

  • This report (attachment removed to protect patient identity) of high-grade TCC (transitional cell carcinoma) with large tumor with muscle invasion is not a good tumor.
  • At this stage, we need to do a metastatic evaluation to rule out any distant spread of this tumor.
  • Hoping that it turns out to be non metastatic and he is in good general health, the best option will be to do radical cystectomy with urinary diversion.
  • The most common diversion performed is ileal conduit to form urinary collection pouch out of a segment of intestine and form a stoma over abdomen where external collection bags can be used.
  • If not operated, the localized high-grade nature will lead to rapid progression of the disease. If metastatic surgery will not help and then, palliation is the target.

Investigations to be done:

LFT (liver function test) and CXR (chest x-ray). If anything suspicious further imaging like bone scan or chest CT. May also undergo PET-CT instead to evaluate for metastasis.

Probable diagnosis:

Carcinoma Bladder T2 G3.

Treatment plan:

Metastatic workup and fitness for surgery

Regarding follow up:

For further information consult a urologist online.---> https://www.icliniq.com/ask-a-doctor-online/urologist


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